HomeMy Public PortalAbout5828TEMPLE CITY BLVD_Electrical (2) ;
7�5A66,17-c�B061t1-T) - APPLICATION FOR. ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ,tt
BUILDING AND SAFETY DIVISION FNEAREST
s ��$ T(3Yr� ry ��e
Y -p- 1� Q t e 70`
FOR APPLICANT TO FILL IN 7 / 'u��S /! /o
ST. L I l6
loo
NO. EACH FEE
I
$ $ OWNER
RECEPT. 7 MAIL
p�p j�
11�� W LQ� SIV
LIGHT i TOTAL FIRST 20 25 ADDRESS'�� ,
SWITCH_ 3 OV9R 20 10 CITY Pat#YD1►A TEL. NO.
PLAN CHECK /1
FIRST 20 ' ,P5 APPLICANT
LIGHTING TOTAL �7
FIXTURES OVER 20 10 �Z5 ADDRESS �,' � I,wJ
RESIDENTIAL APPLIANCES IJ CITY o � TEL. NO.
f 2�b-05
PERMRANGE DRYER_WTR. HTR. APPLICANT 9 , o� 7 c'
CANT
COOK DISP. F.A.U. ADDRESS, 'OVa 26
SPACE HTR. AIR COND. CITY TEL. NO.6 -G/1")
CLOTHES WASH. DISHWASH. LICENSE N0.z p® 2(p CLASS.C-10
FAN OTHER 1.0011 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE JS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER . TO
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR
0 - 1 1,00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF >
CALIFORNIA OR THAT I AM,THE LEGAL OWNER OF, AND INTEND TO O
1 - 10 3.00 RESIDE 1'N, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
U
SIGNATURE
10 - 50 5.00 OF PERMITTEE O
50 - 100 10.00 G
DISTRICT O. CLASS ZONE P OCE59
100 - 500 15.00 5 ' 11 (� I` Luh
SIGN, GAS ][SirD ONE CIRCUIT 5.00 NOTES: Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00
SERVICEOVER600 VOLTS OR 200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT, SYSTEM 9.00
ROUGH CONDIUT
WIRING
FIXTURES
X
PERMIT FEE (SUBPOWER AUTHORIZEDTOTAL) �1
UTILITY CO. NOTIFIED]
PLAN CHECK FEE +�
PERMIT ISSUING FEE 800, FINAL � '��1� ljGq,
_�lot,
TOTAL FEE 10
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. .0. CASH
( p� 0 2 3 573 FAR 29 2 D 4,0 0^' CQIF
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE